Permit CITY OF TIGARD MASTER PERMIT
111 I ' COMMUNITY DEVELOPMENT Permit#: MST2019-00273
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/16/2019
Parcel: 2S107AA03600
Jurisdiction: Tigard
Site address: 16875 SW TOWNSVILLE ST
Subdivision: ROSHAK RIDGE Lot: 36
Project: Polygon at Roshak Ridge, Lot 36
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 1 Bedrooms: 4 First: 809 sf Basement: 0 sf Left: 3 Parking Spaces: 0
Height: 23 Bathrooms: 3 Second: 1049 sf Garage: 437 sf Front: 8 Smoke
Dwelling Units: 1 Third: 0 sf Right: 3
Detectors: Yes
Total: 1858 sf Value: $248,825.69 Rear: 0
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Drains: 0
Tubs/Showers: 3 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 4 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 3
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 3 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Ecom asin Y
Other: N Other Description: p g
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 1858
Owner: Contractor:
POLYGON WLH LLC WILLIAM LYON HOMES INC Required Items and Reports(Conditions)
703 BROADWAY ST STE 510 703 BROADWAY STREET,SUITE 510 1 Ersn Cntrl 503-639-4175
VANCOUVER,WA 98660 VANCOUVER,WA 98660
PHONE: 360-695-7700 PHONE: 360-695-7700
FAX:
Total Fees: $33,682.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notif .tion Center. Th. = es are set forth in OAR
952-001-0010 through OAR-$52-001-0090. You may obtain a copy of the rules or direct questions to OUNC by callin• •3.232.1987 or :00.33 234• r
L_.
Issued By: � .Z1-7—Z---C Permittee Signature: 11Ly"-CA,��ls�
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
....c)
Building Permit Application L___' `-D
Residential JUIN $ FOR OFFICE USE ONE)
City of Tigard Received \q�kG\ Ssk-- Permit No a0�_C `�`
- 23
IIII `� 1h1neS50Ha1l.24 9Tigard,OR 97219 1'F(a anReview71 'I iil /�/�. OtherP.enm ���^ ,�G
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Y rlll
T 1 O A R D Inspection I. 503.639.4175 ci y OF'TIGA to Ready/By. / Ions: ® See Page 2 for
Intemet: www.tigard-or.gov Notified/Method: f Z2�9 Supplemental Information
Ftt!tt fENG DIV'S ON e-71j 9-, 2c,c Cep
Weil��a TYPE OF WORK '%/i j%�i% j 'y
/ ,, % ,. •: ,. 1jIlII113AA 1-AND 2=FAllITL DWELLING
®New construction ❑Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
❑Addition/alteration/replacement 0 Other: equipment,materials,labor,overhead,and the profit for the
CARe` t O� TIO '� �`y/%y/ work indicated on this application.
, , 1, C
® 1-and 2-familydwellingCommercial/industrial Valuation: $
ElAccessory building ElMulti-familyNumber of bedrooms:
❑Master builder 0 Other: Number of bathrooms: 3
S--
„0,0 JOB SI1 1 is N f 1. ,y 9 ,� Total number of floors:
Job site address: 1p y1S 3w---cowv)sv t 1(e St New dwelling area: lbs square feet l Csetk401
City/State/ZIP: 110\0\y I 01�0112? Garage/carport area: q�� square feet 9 09
Suite/bldg./apt.no.: °J Project name:Polygon at Roshak Ridge R►l Vt,1- Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
Other structure area: square feet
REQUIREDDATAzAil 1< 11J I'
Subdivision:-14 vev-i-eyynt,knit Lot no.: 3(10 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: '� Indicate the value(rounded to the nearest dollar)of all
y jj %/j%// work
equipment,materials,lappli
f;f *ii ; work indicated on this application. the profit for the
an
Fletigri
.✓,,,�.>«,',.,.,., .01; .u„�i3rfxo, r. x sad.{,,,,, ,„t ,,,,o,.E :e--- i ,iAm4
Valuation: $
Existing building area: square feet
New building area: square feet
igl PROPERTY' OWNER y LA; Al Number of stories:
Name:Polygon WLH LLC Type of construction:
Address:703 Broadway Street Ste 510 Occupancy groups:
City/State/ZIP:Vancouver,WA 98660 Existing:
Phone:(360)695-7700 Fax:(360)693-4442 New:
Ei APPLTCANT + ❑ CM, -„�i `; - : 1 i I i ry
Business name:Polygon WLH LLC 1
Structural plan review fee(or deposit):
Contact name:Amanda Gavin
FLS plan review fee(if applicable):
Address:703 Broadway St.Ste 510
City/State/ZIP:Vancouver WA 98660 Total fees due upon application:
Amount received
Phone:(360)695-7700 Fax::(360)693-4442
t��i��,�... = F
E-mail:permitsubmittals@polygonhomes.com ,., zt�s„ .w... "'t 'EVS
. .: T�„� i3,Ff-
W
si ' a Commercial and residential prescriptive installation of
--,,,,-,,,2,,,,,,,,- -CONTRACTOR ,t roof-top mounted PhotoVoltaic Solar Panel System.
Business name:William Lyon Homes,Inc. Submit two(2)sets of roof plan with connection details
and fire department access,along with the 2010 Oregon
Address:703 Broadway St.Ste 510 Solar Installation Specialty Code checklist.
City/State/ZIP:Vancouver WA 98660 Permit Fee(includes plan review $180.00
and administrative fees):
Phone:(360)695-7700 Fax:(360)693-4442 State surcharge(12%of permit fee): $21.60
CCB lie.:207247
Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name:Amanda Gavin Date: i a i LI/is
*Fee methodology set by Tri County Building Industry
tai
l Service Board.
i
I:\Building\Pennits\BUP-RESPennitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) e4-4...46, 1-----C-6S ! R—
,
RECEIVE '
Mechanical Permit Application FOR OFFICE ISE ONI,N •
- •••• •
City of Tigard n F C n 82O8 Rr,„,.-cry, ' Pen""Noik\rc,-c?ticl-cr5-12.,
. 13125 SW Hall Blvd.,Tigard.OR 97223
14 Plan Review Other P=Tii:
• 1 °
•,' MD= .'03.7181439 Fax: 199,:ITV OF TIGARD 11311Y--
TURD to.spa,--tion Li= 5 -68.4175 Du Ready:Sy: imIN 1 PI See Page a fur
itnempt vrxw.tisari-or.vre BUILDING DIVISIOMIM: i Supplemental trifurnintioa '
.....:.:,._.,..:,:...„„:,....,:.:1,..,._.,..,f,:,:........-,,,,.,..--,. 7-.-,-.,:::-=- -',..; :i. -.7-------,,----r--.•,..--1:7:...„,...-.7.7.:..,.-.7.727-.L.r..-....:":;,...,....-L:.:-. c 1.4.•1toin_ktpic1A. fEttf' Clitoit:L.V... .EISerktiSt-7.17.'
Mechani=1 permit&Its*are based Orl the value of the%v-est:
tg •
New construaion 0 Addidonialreraionhvlacement *formed.Indicate the Talti (rotarded to the nearest do Hari or oll
.
1:3 Deinolitkin 0 Other mechanical materials.ecrukunerit,Inbar_overhead.and mfg.
Value:S
•.' ''''''';''''':x:7 CATE0.0iii••'Or•CONS‘nitCrIONi;, -**.---.74t1Tirr,-,ii •:,-i,-,.m:‘,;:•:;•,, •,-,-----.1-,--,-,,--,----.4 • •'. - • ,- - -- . ;-.••-•••.
,:.'..f....-._:::,-::±.:::.,...•:•!7_1.•,-,',1:',:',-, .:-.-i••,•-,•••••- : .: .....-: -:•• :••••.•! •••,-: • •••-••••!- :"••,1-•,,,.••-•',.•:--:,--•--- --•--•••'-'7 -'- •-::`.•••:',':-i• .. .•RESTSPAIAVIQUSI.1.40:1CrEE4t'':': •'....•
0 i-and 2-thirdly dwellint 0 CorinuerciatinduStrial 0<Accessory buildint., I Furs-pedal informutlau use theryist
..0 Multi-family 0 Master builder 0 Other: Description , 1 Qty. 1 -En. 1 Total
. .
''''' 41)1i:4F.it..:**41111iiiiTii*iii-k4).'-;iik:k.i.ibrii [si:: :0-2! : :7' ..:'; 14'6nek"ting
Air conditinuirze I
„lob si ad&vesst i I 0 0 1SSt/V1- ' -
0 W II IS VIM ct Furnace 100_000 BTU idlizai:4-eut.s1 1 436.75
.....) .Fumace 103_000+BTU(c1iverirs', 54_91 I
CityStaterZIP:Tigard,OR 97"V_..4
.
41.06 1 i
. Fraject naTacTo 1, 11,0"uti I , t ctg Heat pump
.
s.it...,....,*,.0., , 1
Duct work 23.32 I
__. , .
Cross streetfdirections to jeib site: NrCAI 1-lvdronic liin water aystem 23.32 1
. Residential boiler(radiator or
I ' hYdrottic) I 23,32
_ unit heaters,(fuel-type,Rai electrk).,
in-wall.in-duct.suspended.etc. $6.75
Flue'vent for am of above , 1 , 23,32
Other _ '331
Subdivisitur N u ex Tel-race Ea_s ... 1.4,1 rm.: 34, •.
,Other feel applismer-s-
Tux ruapiparcel no.: Waterheater 2332
. .
1,....-...;.!;',-,•,!,:!•!•:.!:-.':7..•••:.i:0•:..;:!:::: -. ,::•--.:.i. ,:iitgai-titfaik;.0,,iiiikikk:.i.:.: :7::,; . ...,,,,,..,;.:,::,:: :.:,:t ..:,,, . .:., oas rireptimen wed 1_ , 33_39
• ' • Flue vent for water heater or gas
--- .
fimplace 23.32
—... . . Log lighter teas) , 23.32 ..
1 " - -• w - Wood'pellet stove 1 3139
Wood erplacetiosert 23.32
. _
eltiornevAincriflurivent • 23.32
... .. ... _ 23.32
:1:::-..•j ,..:'' ••ErfiNL;VW •..'r , -2. . :,
.1..:-:.:----L-.:".. ''' ''.• ' .. :. '.•'•:,:..;-,-!: '7.:!S'•.,..ig:••-'•'' ‘..,••••"tti:'•". .• '' '''' ' '.. •''' . ''' .:.'''''''*.7' Environmental exhaust and vent:Radom
Nwne: t70 ttArAt ow IA)L4- ULC11 R.,...g,hoodiother kitchen
1 uipment
33_9
2::
Mdmm -' 1 0 Y-)VDMILTAkk9
%-- -e 1()-- I Cequipment
diver=Imam'
I 1 i 33,39
1 citY/suraziP.- TV avi(nuva IK,a, g ie.toD 1 Single-duct exhaust(bathroontc, 1, n I
II tact eumpartertents,utility rooms) 1 i 13.32
51100 .. fox;(VI)10R9)11 Lig 9-- 1 Aitiecravvisiam fans, f I 23 1
. .., .. .. .....
• .
.. .1.•--,.,.1.:::-.:,.. iikridOSt.;?.':: F .tQiit.. fP-Eti50 : ; Other I 2132
.
i Fuel Opinr.
Basinaz name:Polygon WLII,LLC ..14.1 5 for first form.C.4413 for t-Ach unit:16,11=1
N in , . 7"
CMlaci.1144'4-`- rTYY)OtAA(A.0,1 nay 11k) Furnace.nit. 1
Address: 1D3 -R;sYCXXCA,U-)Cl. .t--" t 5ke- k 0, i Imo, , Gas t pump I I
, Wallisuspeudeci!entit healer 1
t
CitytaatelZIP:Vanecrover.,WA 98669 . Waterhemer i
. _
Phone:(160)695-7709 1 i - .
ac:(360)693-4442 Fireplace
. E-Nlatl: erry A-5U-‘.01-Nr. 0.kS a•-/V0k.t3,:jffV1try\-65.CZ Ili 'I
i Barbecue 1 I
iF.;:t700131t kli:1'.,.': ,1. . .....] ..:i.-.4.1it..::117.11g0-(....:..4K. ' 1,_Clodkes drYer l gas) 1 1
Other: 1
BuSineSs=mar Apo Air ELC .
:':•!.P..-7. --,;_.7... .f.20EC;EL.ANIE..-AtztERNirr-.XttS. ;.i!,. :. ,..!.!:......,:,:::•...!•:t..
Addres,s:189134 NE 72 Ave , Subtotal
i Minimum permit fee(S90:00) 1
City/StaleiZTF:Vancouer,WA 913686 1
- Pie .review(25%of pertnit fee)
Plionc•(360)3424169 . I Fax:(360)326.-1769 State surcharge(12%of.peurrit feet l
- l
CCB tic:,2930341,..._ I TOTAL PERMIT FEE
This pertruit plication st; m i,piif*permit is nn obtai;:icA3 witiiin'ISO I
an'S after it has kola.accepted as complete.
Asthorized sign: ature: . - * Fee methodology set by Tri-Counr.;Buildiag Industry Sesgrkt Bend
I .....,,:.--..."'"" ,
i Prim nom I Le\ 1 I Dor: 1,2.1.11.1 G - j
11r-eAthets).Pm.rrivA•IEC-...,OcralitAmp_Wi LI dac 440-4-071"4"/1/11:.'47:04FWEI3
RECEIVED,
•,,.,' OFFICE USE'O 6.
Electrical Permit Application ��l kti�� �, +t �tJ�� a�: ��'; *���. �.���.�,<.
DEC 122019 t t .._�
lirCity of Tigard Received Permit#: �9—Zoo �73
q Date/By: O )
13125 SW Hall Blvd.,Tigard,OR 97223 CITY OF TIGARD Plan Review
Phone: 503.718.2439 Fax: 503.598.I9EUILDING DIVISION Date/BY: Related Permit#:
r, 1. hvi
Inspection Line: 503.639.4175 ReadyDate/By: s: P7 SeePage2for
.TI'GARrc
-w,,,‘,..4,:xva Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF.WORK - . ', PLAN;REVIEW
®New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
El Demolition Other:
0 Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current 0 Marinas and boatyards.
- CATEGORY_OF:CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building
less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other. 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE:INFORMATION.AND'LOCATION: 0 Emergency system. larger separately derived
0 Addition of new motor load of system.
Job#: Job site address:
100HP or more. ❑"A","E","1-2","i-3",
City/State/ZIP:Tigard,OR 97224 0 Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: _ Project name:Polygon At Roshak Ridge 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominaL
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision:Polygon at Roshak Ridge Lot#: 3(0, Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1
• r 2 R ^' DESCRIPTION/� OF W J�1` ' Limited energy,residential
Hn+� til.�/tJj' / s,,r c�w'L�ry-��- (with above sq.ft.) 75.00 2
I h Limited energy,multi-family
/n ST '7„t Q -662-73 residential(with above sq.ft-) 75.00 2
L Renewable Energy ❑.See Page 2
® PROPERTY OWNER'.. ... 0 TENANT. Services or feeders installation,alteration,and/or relocation
Name:William Lyon Homes,Inc. 200 amps or less 100.70 2
Address:703 Broadway St Suite 510 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2
Phone:(360)695-7700 Fax:(360)693-4442 Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 1 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: - Date: 401 amps to 599 amps 168.54 2
®-APPLICANT ❑ CONTACT-PERSON - Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:William Lyon Homes,Inc. above service or feeder fee,
7.42 2
each branch circuit
Contact name:Nichole Thorpe - B.Fee for branch circuits without
sAddress:703 BroadwaySt Suite 510 branche it feederitfee,first 56.18 2
branch circuit
City/State/ZIP:Vancouver,WA 98660 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(360)695-7700 Fax: :(360)693-4442 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:permitsubmittals@polygonhomes.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Alameda Electric Sign or outline lighting 67.84 2
Address:3415 NE 44th Signal circuit(s)or limited-energy 0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Portland,OR 97213 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)319-2192 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:solarpdx@me.com •
Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
90.00/hr
CCB Lic.: 199188 Electrical Lic.: c923 Suprv.Lic.: 487 '5 specifically listed('/z hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Kile Rood Date: 03/08/2019 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: _— TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Kile Rood Date: 03/08/2019 days after it has been accepted as complete.
k ).1.....1.......F: .........11...,..........:•
Plumbing Permit Application
Building Fixtures
City of Tigard Received
II k# 13125 SW Hall Blvd_Tinard,OR 4,,t
-i :11 Oil I 1GARD DatelBY:
Plan Review Permit No \C„,c-T2J(..)\CI
: =
Phone: 503.718.2439 Fax: 5 pit9tiN Other Permit No.:
Inspection Line: 503.639.4175 p U G DIVISION Date/By:
TIGARD , Date Ready/13y. Ives: i71 See Page 2 for
Internet: www..ligard-Or.gOV Notified/Method: Supplemental Information
TYPE OF WORK .. , . .FEE' SCHEDULE
kr
New construction C Demolition For special information use checklist
•
Description I Qty. I Ea. I Total
0 Addition/alteration/replacement LI Other: New 1-2-family dwellings(includes 109 ft for each utility connection)
CATEGORN OF CONSTRUCTION SFR(1)bath 312.70
NI 1-and 2-family dwelling CD Commercial/industrial SFR(2)bath 437.78
SFR(3)bath 1 500.32
D Accessory building 0 Multi-family
Each additional hathildtchen 25.02
0 Master builder LI Other: Fire sprinkler( sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Jobsite address.: (0 '11S 5VIc V[OIL c-t- Catch basin or areadrain
18.76
Drywell,leach line,or trench drain
18.76
City/State/ZIP:Tigard,OR 97224
Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: Project name:ill()IVA,RA---pmc tut
0 / I Manufactured home utilities 50.03
Cross streetldirections to job site: 0 Ka 4,-. Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no,linear ft,: ) Page 2
Storm sewer(no.linear ft.: ) Page 2
Water service(no,linear ft.: ) Page 2
Subdivision:I putritiormq,Ots- Lot no.: 3te Fixture or item:
Backflow preventer 31.27
Tax map/parcel no.: ,.44:,„
- Backwater valve 1 ° 12.51
- - DESCRIPTION OF WORK
Clothes washer 25.02
Dishwasher I 25.02
Drinking fountain 25.02
Ejectorsisump 25.02
erli PROPERTY OWNER El TENANT - . Expansion tank 12.51
Fixture/sewer cap 25.02
Name:
Po tAoini\,vou4, L(c,
Floor drain/floor sink/hub 25.02
Address: 1 0 23
- 7rod6iu•)otni\ -t- 6-01-(. 10 Garbage disposal 25.02
eltY/StatcalP: V ot Vi (1oavev iA)ct ciWle DO Hose bib 25.02
Phone: (.fi 0(0 01 11 00 Fax:( m)(06(.27 l'Iqq.2- Ice maker 12.51
C4 APPLICA-Nr- 0 CONTACF PERSON intercinterceptor/grease trap '>5.07
Medical gas(value:$ ) Page 2
Business nameV70\ 0 ii uuk. uL
y4
Printer
Roof drain(cm omereial) 1.2.51
12.51
Contact name: elavilk)
Address: 1 0 ) Y2 y 0 CtoWja M --\'" C71-tez g 0 Sinkbasinllavatory 25.02
City/State/ZIP:Vancouver,WA 98660 Solar units(potable water) 62.54
Phone:(360)695-7700 Fax::(360)693-4442 Tub/shower/shower pan 12.51
Urinal 25.02
E-mail: perm rt- titbimit-1-1-rtIS 0 1201 Ii)o3DY),In.DM( U) Water closet 25.02
37.52Waterheater
Business name: G4- kAiwtjb .,,,
n _,, ?L,.. Water piping/DWV 5629
Address: 45.ti, f, ov.4 cta Other: 25,02
City/State/ZIP: 51', e 4.14-1/4 Oft, Ct Pi 131 Subtotal
Minimum permit fee: £72.50
Phone:(453 .--13(4.-- f441 Fax:(11 V...0-741.-47 11,0 _
Plan review (25%of permit fee)
CCB Lie.: Plumbing Lie.no.Pb 431
State surcharge(12%of permit fee)
Authorized sigoture: AIS- Ajot 17:Xit,Itfr""`" TOTAL PERIAIT FEE
Print name: „S-1-'Wt. W14..e............. -pate.c- lai qj it 1 This permit application expires if a permit is not obtained within 186 days
after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
VauildinetrmiiikPLIAll-P,,mitApp.doe 10/01/09 404616T(10102(COMAVER)
City of Tigard
11 a COMMUNITY DEVELOPMENT DEPARTMENT
I
T 1 G A x n Building Permit Review — Residential
Building Permit #: c--. -CACA-
Site Address: Ze e'?"<---- k 7l0n�l/i/il S117
Project Name: PO10-07) i&cAL ,e/� _-Lot #: ,e(New dwesubdivision name;Addition or Alteration=I t me of owner)
Planning Review
Pro osal: G -eto Q Fie z
• Verify address/suite# active in Accela. In River Terra e: ❑ No L/J Yes,River Terrace Review Addendum
Sit Plan Elements: p f ro ion Control
copies of site plan on 8-1/2"x 11"or 11 x 17"paper j la 4-tained trees with drip line and tree protection measures
f awn to scale(standard architect or engineer scale) TA Fgotprint of new structure(including decks) and FFE
• Orth arrow [ZtJ 1. ty locations&easements(required for new and additions)
ViSite address,project or subdivision name and lot number G Sidewalk/driveway approach
✓ plicant information(name and phone number) 11�! ation of wells/septic systems
Lot dimensions and building setback dimensions ►.S eet tree size,type and location
to�, are footage of buildings to be demolished beet names
J '1'.<sting structures on site t/J Corner elevations(2'contours if more than 4'diffee i tial)
TI Lot area,building coverage area,percentage of coverage and >1,000 sf of impervious area created or replaced? 1Q Yes 0
impervious area(applicable if R-7,R-12,R-25&R-40) If yes,is a storm water quality facility shown? ]Yes No
(Clean Water Services—Service Provider Lettee of platted prior to 9/10/1995):
equired: ❑ Yes,applicant was notified is No Received: ❑ Yes ❑ No
✓ Public Faciliti Improvement (PFI) Permit:
Required: y s,applicant was notified ❑ No Applied r: Yes� ❑ o,stop intake
, nd Use Case#: L' oI �/yoo 21- Zoning: �b)
1L equired Setbacks: Front: Rear: Cf' /Side: Street Side: � Garage:
izilding Height: Max. Height: Actual Hei ht:
.! Landscape Area: 0 % Lot Coverage Max: b °/o
Entrance \ - back no more than 8'from street-facing wall ❑ Parallel to street or offset 45 degrees s i
Windows ❑ Minimum °, of area of all street-facing facades
Garage D Garage door is behins .-st street-facing wall Yes ❑ ane of ollowing is met:
❑ Door extends no more than ' . .m wall and there is a co - -. porch extending beyond garage.
D Door extends no more than 5'from wa i : •. -- e is a 12 sq ft.window above garage on 2nd floor.
❑ Garage door width is ❑ 12'or les 2 50%or less • • ade ❑ 60%or less and includes 7 of following:
❑ Covered porch U 'ecessed entrance ❑ Wall offset 2. 'Roof eave ❑ Roof offset
D Fire . •es ❑ Lap Siding ❑ Roof pitch ❑ Gable,hip,or :. .rel roof ❑ Dormer
2 Accent siding Window trim ❑ Window recess D Window projec i.- ❑ Balcony
ITN sual Clearance yrban Forestry Plan
lig
ensitive Lands: l!Q Yes ❑ No Type: �iv—V /ui /777'
'[ Conditions met prior to issuance of building permit
No s: _ /
Approved By Planning: -- Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
L:\Building\Forms\B ldgPernvtRvw_RES_022819.docx
. I
Building Permit Submittal
Original Submittal Date: 1-.I 1(S(
Site Plans: # 3
Building Plans: # 3
Building Permit#: R"Enter building permit#above.
Workflow Routing: Planning ["Engineering ['Permit Coordinator Building
Workflow Sign-off: [El' Sign-off for Planning(include notes from planning review)
Route Application Documents: EY Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
['Building: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: \ 4:(1_,A__,‘.._.,,,_- Date: --4-(q'\ t
MIN
Engineering Review
[?7 Slope at building pad: °A
Q Conditions"Met"prior to issuance of building permit
Q Easements (encroachments)per engineering conditions of approval and plat
Er Water Quality/Quantity Facility: 1
Assess Water Quality Fee in-lieu: 0 Yes LI No
Assess Water Quantity Fee in-lieu: 0 Yes 0 No
LIDA Facility on lot: 0 Yes 0 No
0 Final Plat Recorded:
O NOT Approved by Engineering: Date:
Notes:
Cr Approved by Engineering: ( ^'4O41 ' Date: 7 • 0 • 2 '/
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved 0 Not Approved
Revision 2: 0 Approved 0 Not Approved
Revision 3: 0 Approved 0 Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
030C Fees Entered: Wash Co Trans Dev Tax: likes ❑ N/A
Tigard Trans SDC: L� �Yes 0 N/A
Parks SDC: LP4es 0 A
LIDA ❑ Yes /A
OK to Issue Permit
Approved by Permit Coordinator:
dttV Date: //0/fi1
I:\Building\Forms\BldgPermitRvw_RES_022819.docx
}
City of Tigard
IIIIIICOMMUNITY DEVELOPMENT DEPARTMENT
C
TIGARD River Terrace Building Permit Review Addendum
Building Permit #: `c1C\-� , ~6
Site Address: b ,() 'MUA2CVI/Zt
Project Name: A� 11 E0sd4V, r-'� Lot #: _y Z
(New dv �f lg= subdivision name;Addition or Alteration=last e o owner)
Planning Review of River Terrace Plan Dist 'ct Design Standards (18.640.070.1):
Is the project subject to the plan district design standards? Yes ❑ No
1.Articulation: a minimum of 1 element per each street-facing facade that has 30-60 ft. of frontage.An additional
element required for lots with over 60 ft. of street frontage shall be provided every 30 ft.
Balcony w/ access 2 Window Projection Vertical Wall Offset a
Porch min. 5 deep ft. deep min. 2ft.,5 ft. wide min. 2 ft., 6ft.wide Gabled dormer
❑ ❑ ❑ ❑
2. Eyes on the street: a minimum of 12°°o of each street facing facade must include windows or entrance doors.
Percentage Shown: )t
E rances:At least one entrance must meet both of the folio g standards:
3. Max. 8 ft. setback from longest street- facing wall Parallel to street,angle no more than 45° from street,
or open onto porch
Entrance opens to a porch: Zes ❑ No 4Cf-sq.ft.
If y ,all the following apply: min.
e street facing entry gft. max. roof above floor of porch
Ild 5 tt. depth min. 30%min. porch roof coverage
4. D tailed Design:All buildings shall include a min. of five of the following elements on all street-facing facades:
Covered porch min. 5 ft.wide x 5 ft. deep ❑ Recessed entry area min. 5 ft.wide x 2 ft. deep
❑ } *all offset min. 16 inches ❑ Tuner min. 4 ft.wide
Roof eave min. 12 inch projection �/ of offset min. of 2 ft.
❑ Roof shingles either tile or wood Ia Gable, hip or gambrel roof design
❑ Ij.00f pitch oriented south min. 500 sq. ft. ❑ Horizontal lap siding min. 3 7 inches wide
Accent siding min. 40%of street facade ❑ Window trim min. 2 '/2"wide by 5/8" deep
❑ Window recess min. 3 inches for all street facing ❑ Bay window min. 5 ft. wide by 2 ft. deep
❑ Balcony min. 5 ft.wide x 3 ft. deep with inside access ❑ Attached garage is 35% or less of street facade
. , •es and Carports: May face the front or side lot liTepory a corner lot.
Setbacks: 1
No closer to front or side o :.•- than longest street-fa . g wall. ❑ Yes ❑ No. If Noche One):
❑ May extend up to 5 ft. if there is a coy- -; ont porch and garage doe_ .: -xtend beyond the front porch.
❑ May extend up to 5 ft. where the garage is part of a z'a %.s, Building and there is a window at the second story
above the garage that faces the street with a •• -a of 12 sq.ft.
Width: (Check one)
❑ 12-foot-wit- . age door ❑ 40%max. of street facade
• i'o max. of street facade with 7 detailed design elements
Notes:
Approved By Planning: -- - J Date: I
1i\Building\Forms BldgPermitRvw_RES_RT_121417 docx
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
= Transmittal Letter
T I G A R[D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: Ai I S U VA AV J- Y OV1 DATE RECEIVED:
DEPT: BUILG DIVISION RECEIVED
1� f� ew V1 !1 JAN `L 8 ?,.019
FROM: rm VvViL I! t CITY Or iit1ARG
COMPANY: RI IT 0 VO 1\3 vtaS BUILDING DIVISION
PHONE: (7O?-J 41 n---) 010 By '/#
RE: �li' > s S 1D Y V��V\\\"e flct �Ur / IS1- Z % t --
(Site Address) 1- (Permit Number)
\1-49, �- (�, l V t' _f lel ^(A it ( 1io
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description:
Additional set(s) of plans. Revisions: r\\ �?
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS:
FO TICE USE ONLY
Routed to Permit Technician: Date: 7 [L, t Initials: AA--
Fees Due: ID Yes p,No Fee Desc ptio : Amount Due:
ii\.)
Special
Instructions:
Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done
Applicant Notified: Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions_061316.doc